Everything, and the connection works step by step.
Healing needs a supply. As a wound heals, blood vessels open in the area so blood can bring oxygen and nutrients to the wound. Oxygen is essential for healing.
Poor circulation is a failure of that supply. With ischemic ulcers, narrowed arteries prevent a healthy supply of blood from flowing to the legs, which means the tissues do not get enough nutrients and oxygen. The lack of nutrients causes cells to die, damaging the tissue. And damaged tissue that does not get enough blood flow also tends to heal more slowly.
That last part is the circular part, and it is why these wounds are difficult. Poor blood flow helps cause the wound, and then makes the wound slow to heal.
It is not only arteries. Poor blood flow is one of the things that can prevent wounds from healing, and it may be due to clogged arteries or conditions such as varicose veins. Put another way, it is poor circulation due to damage to arteries or veins. Blood that cannot arrive and blood that cannot leave are both circulation problems, and they are treated differently.
That’s why the exam includes it. At a first appointment, a wound care team checks the blood flow in the area around the wound, along with examining and measuring the wound, figuring out why it is not healing, and creating a treatment plan.
And it’s why the treatments differ. For a venous ulcer, compression every day. For an ischemic ulcer, blood flow to your legs needs to be restored, you may need medicine, and in some cases you may need surgery. Don’t use compression on an ischemic ulcer unless a provider has said so, because it may restrict blood flow.